Knowledge and attitude regarding HIV/AIDS among patients attending medicine outpatient department in C. C. M. Medical College and Hospital, Durg

Background: Acquired immunodeficiency syndrome (AIDS) is one of the deadliest diseases that modern medicine has ever had to tackle. Understanding the knowledge about HIV/AIDS in general populations will help in formulating strategy for prevention and treatment. With this background, this study was conducted to assess the knowledge and awareness about HIV/AIDS among general population.Methods: A cross sectional study was conducted at C.C.M. Medical College and Hospital, Durg during December 2018 to January 2019. The data was collected from 450 patients attending the medicine outpatient department. Study subjects were selected using convenient sampling technique. Patients giving consent and willing to participate were included in the study. The data was collected in predesigned and pretested questionnaire.Results: 77.11% study participants were aware that unprotected sex can lead to transmission of HIV, 73.78% knew that shaking hands will not transmit the disease. 79.8% knew that use of condom can prevent transmission of HIV/AIDS. Overall males had better knowledge than females. 76.85% said they would behave friendly with people having HIV/AIDS and 69.78% were willing to take care of relatives with HIV.Conclusions: This study indicates that majority participants have good knowledge about difference between HIV and AIDS, modes of transmission and prevention though they were not completely aware of it. The proportion of those with lack of correct knowledge though comparatively less, needs to be taken as a challenge and addressed through well planned health educational activities at various platforms including teaching hospital premises.

Pattern and incidence of adverse drug reactions observed in cardiac clinic of tertiary hospital, Hakeem Abdul Hameed Centenary Hospital, Jamia Hamdard, New Delhi.

Background: The aim of the present study was to monitor the incidence and pattern of adverse drug reactions (ADRs) in cardiac care unit at Hakeem Abdul Hameed (HAH) Centenary Hospital. Methods: Study was conducted with the permission of Institutional Ethics Committee. Patients visiting medicine outpatient department, cardiac clinic, medical ward, and emergency departments over a period of 15 months were recruited. ADRs were recorded on the prescribed form. Causality assessment was done using Naranjo probability scale. 223 patients of hypertension and stable coronary artery disease were enrolled of which 48.9% were males and 51.1% females. The most common prescribed drugs were ace-inhibitors, angiotensin receptor blocker, and beta-blockers. Other prescribed drugs were calcium channel blockers, statins, nitrates, and antiplatelets. Results: A total of 44 ADRs were recorded. 26 ADRs were seen in females and 18 in males. Statins were the commonest drug associated with ADRs (29.5%) in our study. The most common organ system associated with ADRs in the present study was central nervous system followed by skin 15.9% each. The incidence of ADRs was about 20% of which 20% ADRs were probable, and 80% were possible. Maximum ADRs occurred in patients prescribed statins followed by beta-blockers and angiotensin receptor blockers. Conclusion: There is a need for conducting such studies in more and more patients to see the pattern of ADRs in cardiac patients. More information will help in reducing the ADR occurrence and making drug use more rational and safe for patients.

Calotropis procera root extracts block VEGF-induced angiogenesis: Quantitative analysis.

Angiogenesis is controlled by number of growth factors, including vascular endothelial growth factor (VEGF). Plant derived anti-angiogenic molecules acting via VEGF are being investigated for curtailing angiogenesis dependent diseases. In this study, methanolic (CM), n-hexane (CH), ethylacetate (CE) and water (CW) extracts of the roots of Calotropis procera were tested for anti-angiogenic activity. In the chicken egg chorioallantoic membrane (CAM) assay, CM, CH and CE but not CW inhibited VEGFinduced neovascularization in a dose-dependent manner. Of all the tested extracts, CM at the dose of 10, 5 and 2.5 ng most effectively inhibited over 83, 71 and 64%, of neovascularization induced by 10ng of VEGF, respectively. Sponge implantation assay in mice further showed that at the dose of 100ng CM, CH and CE but not CW significantly inhibited neovascularization induced by VEGF (100 ng). Taken together, this study indicates that the root extracts of C.procera may possess anti-angiogenic activity.

Evaluation of anticataract potential of Triphala in selenite-induced cataract: In vitro and in vivo studies.

Triphala (TP) is composed of Emblica officinalis, Terminalia chebula, and Terminalia belerica. The present study was undertaken to evaluate its anticataract potential in vitro and in vivo in a selenite-induced experimental model of cataract. In vitro enucleated rat lenses were maintained in organ culture containing Dulbecco’s Modified Eagles Medium alone or with the addition of 100μM selenite. These served as the normal and control groups, respectively. In the test group, the medium was supplemented with selenite and different concentrations of TP aqueous extract. The lenses were incubated for 24 h at 37°C. After incubation, the lenses were processed to estimate reduced glutathione (GSH), lipid peroxidation product, and antioxidant enzymes. In vivo selenite cataract was induced in 9-day-old rat pups by subcutaneous injection of sodium selenite (25 μmole/kg body weight). The test groups received 25, 50, and 75 mg/kg of TP intraperitoneally 4 h before the selenite challenge. At the end of the study period, the rats' eyes were examined by slit-lamp. TP significantly (P < 0.01) restored GSH and decreased malondialdehyde levels. A significant restoration in the activities of antioxidant enzymes such as superoxide dismutase (P < 0.05), catalase (P < 0.05), glutathione peroxidase (P < 0.05), and glutathione-s-transferase (P < 0.005) was observed in the TP-supplemented group compared to controls. In vivo TF 25mg/kg developed only 20% nuclear cataract as compared to 100% in control. TP prevents or retards experimental selenite-induced cataract. This effect may be due to antioxidant activity. Further studies are warranted to explore its role in human cataract.

Current concepts in the pathophysiology of glaucoma.

Glaucoma, the second leading cause of blindness, is characterized by changes in the optic disc and visual field defects. The elevated intraocular pressure was considered the prime factor responsible for the glaucomatous optic neuropathy involving death of retinal ganglion cells and their axons. Extensive investigations into the pathophysiology of glaucoma now reveal the role of multiple factors in the development of retinal ganglion cell death. A better understanding of the pathophysiological mechanisms involved in the onset and progression of glaucomatous optic neuropathy is crucial in the development of better therapeutic options. This review is an effort to summarize the current concepts in the pathophysiology of glaucoma so that newer therapeutic targets can be recognized.The literature available in the National Medical Library and online Pubmed search engine was used for literature review.

Oculohypotensive effects of foeniculum vulgare in experimental models of glaucoma.

PURPOSE: Evaluation of oculohypotensive activity of single drop application of aqueous extract of Foeniculum vulgare in experimental models of glaucoma. METHODS: The evaluation of oculohypotensive activity of Foeniculum vulgare was done in rabbits with normal intraocular pressure (IOP) and with experimentally elevated IOP. The experimental increase in IOP was achieved using water loading and steroid induced glaucoma models. RESULTS: The aqueous seed extract of Foeniculum vulgare exhibited 17.49, 21.16 and 22.03% reduction of intraocular pressure (IOP) in normotensive rabbits at 0.3%, 0.6% and 1.2% (w/v) concentrations respectively. The 0.6% concentration was further evaluated in acute and chronic models of glaucoma. A maximum mean difference of 31.20% was observed between vehicle treated and extract treated eyes in water loading model while a maximum mean IOP lowering of 31.29% was observed in steroid induced model of glaucoma. CONCLUSIONS: The aqueous extract of Foeniculum vulgare possesses significant oculohypotensive activity, which was found to be comparable to that of timolol. Further investigations into the mechanism of action, possible toxicity and human clinical trials are warranted before the Foeniculum vulgare finds place in the arsenal of antiglaucoma drugs prescribed by physicians.

Nasopharyngeal carriage of Streptococcus pneumoniae.

OBJECTIVE: To determine nasopharyngeal carriage rate and prevalent serogroups/types (SGT) of S. pneumoniae in healthy children, assess their antimicrobial susceptibility and its implications over the heptavalent pneumococcal conjugate vaccine. METHODS: 200 healthy children aged between 3 months and 3 years attending Pediatric OPD at Sir Ganga Ram Hospital, New Delhi were studied. A nasopharyngeal swab was collected from each child which was processed to isolate Streptococcus pneumoniae. Serotyping was performed by the Quellung reaction. Antimicrobial susceptibility patterns were determined by disk diffusion and E test methods. RESULTS: S. pneumoniae carriage rate was 6.5%. Isolates belonged to serotypes 1, 6, 14 and 19, of which serotype 19 was the most common. None of the strains were totally resistant to penicillin though 2 (15.4%) were intermediately resistant. Overall, 84.6% of the isolates belonged to the strains covered by the heptavalent pneumococcal vaccine. CONCLUSION: The heptavalent conjugate vaccine covers most isolated strains, but since the number of strains is very small, it is suggested that there is need for further studies in different regions to assess the usefulness of this vaccine.

Retinal toxicity of intravitreally injected plain and liposome formulation of fluconazole in rabbit eye.

PURPOSE: Candidal endophthalmitis is a sight-threatening ocular infection that most frequently occurs as a complication of candidemia. Fluconazole has been effective against Candida albicans in various animal models. Our objective was to evaluate retinal toxicity of plain and liposome formulation of fluconazole at various dose levels after intravitreal injection. MATERIALS AND METHODS: Twelve New Zealand albino rabbits weighing 2-2.5 kg were used. Two rabbits were used for every dose level. Liposome formulation containing 100 and 200 microg of fluconazole in sterile phosphate buffer solution and plain fluconazole at concentrations of 100, 200, 400 and 800 microg in 0.1 ml of sterile normal saline were injected intravitreally into the right eyes. The left eyes received 0.1 ml normal saline or 0.1 ml of liposome formulation without fluconazole. One week later, the animals were sacrificed, their eyes enucleated and processed for light microscopy and scanning electron microscopy. RESULTS: It showed that plain fluconazole at a concentration of 100 microg and above caused retinal changes, with disorganization of the photoreceptor outer segments. However, liposome formulation of fluconazole (200 microg/0.1 ml) did not show any significant microscopic changes of the retina. CONCLUSION: The liposome formulation decreased the retinal toxicity of fluconazole up to the studied concentration of 200 microg/0.1 ml.

Disposable diapers: safe and effective.

Nappy rash is a common problem in infants due to their thinner skin, wetness, heat and friction under cloth nappy, fecal enzymes and alkaline urine. The disposable diapers containing Super Absorbent Material (SAM) reduce the incidence of nappy rash. SAM quickly absorbs urine and keeps the skin dry. Also disposable diapers prevent fecal contamination by absorbing the urine and containing stools.

AgNOR counts are not altered in alcoholic cirrhosis.

One hundred and two liver biopsy specimens were stained for Argyrophilic nucleolar organizer regions and associated proteins to assess its utility in differentiating normal, cirrhotic and neoplastic liver tissue. A statistically significant (p < 0.001) difference was observed between mean AgNOR counts of normal (1.53 +/- 0.4), post-hepatitic cirrhosis (3.65 +/- 0.53) and hepatocellular carcinoma (7.94 +/- 1.18). In contrast the mean AgNOR count of biopsies with alcoholic cirrhosis (1.57 +/- 0.06) was significantly less (p < 0.001) than post-hepatitic cirrhosis and was similar to that of normal liver tissue. It is concluded that AgNORs can act as a good adjuvant to histology in diagnosing liver diseases especially in differentiating post-hepatitic and alcoholic cirrhosis.

Current trends in wound management.

Laceration and wound are common emergencies for which children are brought to emergency room. Pediatricians can manage most of these himself. Recently few more methods have become available for wound closure, which are very useful to pediatricians in their office settings. This article stresses on the current trends in wound management. A tidy wound can be repaired primarily while untidy wound requires conversion to tidy wound before closure. Host and environmental factors, which can affect wound healing, should be identified and managed accordingly. Parental presence can be very useful in certain cases. Wound should be examined and irrigated thoroughly to remove foreign bodies and debris. Associated injuries should be assessed and treated appropriately. Suturing, staplers or tissue adhesives can do the wound closure. Last method is particularly useful in pediatric office settings. Antibiotics are needed in certain selected conditions.

Poisoned child: emergency room management.

Poisoning is one of the commonest pediatric emergencies. Most of poisonings in children below 5 years of age, are accidental and fortunately trivial, related to their exploratory nature. However a poisoned child may present as an acute emergency with or without multisystem involvement. The initial phase of management focuses on support of airways, breathing and cardiac function (ABCD of Resuscitation). The second phase includes Evaluation and Detoxification phase. The Evaluation phase involves identification and severity of toxic exposure. Recognizing a Toxidrome (constellation of the signs and symptoms seen with the ingestion of a particular poison) is particularly very helpful when the child presents with an unknown poisoning. Detoxification should proceed simultaneously. The current literature suggests that activated charcoal is the mainstay of GI decontarmination. Whole bowel Irrigation is a new addition to the armamentarium of GI decontamination. At present antidotes are available for few toxins only so the management remains supportive for most poisons.